Abstract: Background: According to the mandate of Indonesian Constitution 1945 and decentralization law, one of the obligatory affairs of the district government is health sector. To ensure that all people are covered with health services then the policy about Minimum Standard Service (MSS) in health affairs was issued. Objective: This study aimed to investigate the implementation of MSS in health affairs of Enrekang from 2013-2015. Materials and Methods: This study was cross sectional by using quantitative and qualitative approach. Implementation measured was determined by analysis of budget supporting, the achievement of indicators and public satisfaction. The primary data, constraints of implementation, was observed in this study, while the secondary data collected were district characteristics and 22 indicators of MSS. A total of 8 key informants were interviewed including the head of the health office, divisions in health office and Puskesmas as well as patients in Puskesmas and the local hospital. Selection of informants used snowball sampling. Results: This study indicated that the budget allocation is still low (less than 10%). Achievements in implementation of MSS policy decreased from 40.9% (2013) to 31.8% (2015). In 2015, the lowest achievement was referral health services, while the highest was health promotion (32 vs. 100%). There are several constraints experienced, particularly the difficulties to understand the guidelines and incompatibility of data management with the guidelines. However, people are satisfied with the services obtained. Conclusion: It is concluded that the implementation of MSS in health affairs might be influenced comprehensively such as, different perception of health workers in understanding the indicators, budget supporting and the number of human resources. The public satisfaction was independent and it is strongly related to the cost of services.